resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
March, 2005, Vol. 05, Issue 03
The Inside-Out Paradigm: Equalizing the Pressure
By Dale G. Alexander, LMT, MA, PhD
Read Dale's previous article, "Healing From the Core: A New Paradigm," Parts 1 & 2, in the Sept. and Oct. 2004 issues of Massage Today at: www.massagetoday.com/archives/2004/09/20.html and www.massagetoday.com/archives/2004/10/04.html.
This article will explore a few of the many elements of anatomy and physiology that are fundamental to the proposed paradigm of working from the "inside-out." My first article, "Healing From the Core: A New Paradigm," postulated three core elements that assist the healing process:
The centerpiece of this paradigm is simply to work with how the body maintains itself physiologically and proprioceptively at the same time. Most biomechanical models infer that the source of constricted vascular circulation is the result of the extrinsic musculature's battle to maintain body posture within and against the field of gravity. This is partially accurate. However, it is postulated that contraction of the visceral suspension is a more primary source of vascular congestion and that much of what throws the proprioceptive balance off in the first place is the result of how the body discharges visceral tension into the intrinsic musculature, which then affects the kinetic chain of the joints, thus placing a demand on the extrinsic musculature to contract in order to protect individual joints and the overall balance of an individual. It is a complex both/and scenario. But with further exploration, it will become clearer.
An overlooked aspect of anatomy in our work as massage therapists is that the human body has three great cavities designed to assist the movement of fluids and support the upright carriage of our human structure based on the pressure differences between them. These are the abdominal-pelvic; the thorax; and the cranium.
According to Dr. Jean-Pierre Barral, the developer of Visceral Manipulation, the pressure of the thoracic cavity in a healthy system is negative in relation to the more positive pressures within abdominal-pelvic and cranial cavities. This negative pressure also acts like a helium balloon to support our posture in the field of gravity.1
This difference in the pressure relationships between the cavities is how the efficiency of the low pressure venous and lymphatic systems is normally maintained in their job of returning their fluids back to the heart and lungs to be re-nourished and recycled. Let us remember that fluid moves from an area of greater concentration to an area of lesser concentration naturally. Thus, as one assists the body to re-establish the negative pressure within the thoracic cavity, it allows for an equalization of pressures between the cavities.
How does one tell if the thoracic pressure has become more positive with a client on your massage table? Simple palpation and soft compression of the thorax will readily indicate to you the degree of positive pressure. The less flexible the thorax, the more positive the pressure and, by inference, the slower the flow of venous and lymph return.
Within the body's three great cavities are four visceral sacs:
Each of these sacs is related to physiological waves of expansion and contraction, which are crucial to normal fluid circulation. Their rhythms support the healing process and maintain normal homeostatic regulation:
All of these rhythms are influenced by the pressure within the cavities and sacs, and by the pressure of the tubes within the sacs and by the pressure within those tubes, which pass between the sacs and cavities. Obviously, this adds emphasis to the tone and length of the esophagus, as it is the connecting tube between the cranial vault, thoracic cavity, and abdominal/pelvic cavity. It offers a release valve to the pressures, which often build up within the alimentary canal in addition to the anus at the lower end.
These rhythms are homeostatically regulated between the two divisions of the Autonomic Nervous System; the parasympathetic outflow of the vagus and pelvic splanchnic nerves and the sympathetic nerves exiting from T1-L2 of the spinal cord. It is the flexibility between these two divisions, which regulates who gets the blood thereby the oxygen and nutrients needed to support the healing process.2
How does this pressure in the tubes, sacs and cavities build in the first place? By soft-tissue contraction of the sacs and tubes of the viscera, which lessens the space for the liquids and gases within them. This internal contraction pressurizes the contents. When this pressure is unable to equalize, it builds. The building of pressure creates more soft-tissue tension. The cycle repeats again and again. The body attempts to distribute these tensions both directly and reflexively.
The theorized direct method was described in the first article: visceral tensions build, then spill over into the intrinsic musculature, which then pull on the osseous system until a dysfunction of motion is created affecting joint range of motion. This both releases some of the internal pressure, but also stimulates the extrinsic musculature to contract to protect the joints from further displacement. Inevitably, one's posture and sense of balance is also affected.
The reflexive method involves the distribution of tensions and strain through more generalized viscero-somatic reflex arcs. These relate to both segmental levels of the spinal cord and regional areas that have come to be recognized by surgeons as indicators of acute organ pathology.
What I've come to realize is that the body is organized to use the joints of the axial and appendicular skeleton in a very similar fashion to an electrical circuit-breaker system in a more modern home. Organ correlation to segmental levels of the spinal cord are referred to as spinal correspondences and are maps to the work of chiropractors and the osteopaths who directly manipulate the joints.
Regional reflex areas, such as the right shoulder/scapula area associated with liver/gall bladder congestion, stasis and disease, are referenced in some medical textbooks but are more commonly found, and their relevance more usefully described, in surgical references.3
The paradigm of working from the "inside-out" suggests that as massage therapists, we need to learn how to equalize the pressures within the tubes, sacs, and cavities of the body as a first step to assisting our clients. Additionally, knowledge of the aforementioned spinal correspondences and regional reflex areas can be invaluable for making timely and appropriate referral of our clients to medical care from the onset of working with them, or when they are not making progress.
Competent massage therapy of any orientation will assist stress-induced states of congestion to dissipate with a lessening or disappearance of the initial symptoms. When this doesn't occur, it is our ethical responsibility to encourage medical evaluation. A "well-baby" visit to a physician can be invaluable to the mental health of a client who fears something is amiss.
Stress-related problems follow the progression offered in the first article: adaptation, compensation/substitution, injury/illness, degeneration/disease. Trauma simply speeds one along the continuum. It is common for a client to have all the relevant medical tests and return for additional work as what is brewing within them has not reached the tipping point of recognizable pathology.
Now to lightly kiss the question of why stress affects some people more than others and some in particular areas, while others in totally different ways. As humans, we assign meaning to our experiences in life. We develop a complex array of positive and negative anticipations to events. We live in the models of our mind more than in the present time, experience of life unfolding moment by moment. This is the arena of consciousness and is the most powerful tool for change and evolution for ourselves and our species.
My experience professionally and personally reflects an additional existential theorem, as well: Our bodies are our vehicles for the development of consciousness, the growth of our soul and spirit, and the integration of our personality and spirit. Our bodies are where the action is happening. It embodies our confusions and terrors, our willingness and readiness for change. The body really does reflect a Map of Consciousness.4
Touch bridges time and space, and is the vehicle for re-modeling our inner landscape of attitudes, possibilities and behavior.
For those new to the profession, much of this may have been more than a mouthful, or simply tedious reading, yet it is what we are challenged to hold in our work, and there is more. It has taken years of concentrated experience and study across many disciplines to tease apart the foundational elements of anatomy and physiology to make sense of how the gestalt of the body works in relation to its dance with the psyche.
In truth, this paradigm of working from the inside-out is only the springboard for many connections that are to come in future years.
These basics, and others to follow, have consistently shown themselves to be fundamental to working with clients, especially those with chronic problems. Our real challenge is to expand our perception broadly to include additional dimensions and to nurture our quality of touch to assist our clients to integrate themselves across the many levels of human consciousness.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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